Unexpected Foreign Body Insertion Presenting as an Abdominal Mass in an Adolescent: A Case of Underlying Psychological Distress

Abstract

We report the case of a 13-year-old female who presented with a painful, inflammatory mass in the left hypochondrium. Imaging studies revealed multiple subcutaneous foreign bodies, including metallic fragments and non-metallic objects. Surgical exploration under general anesthesia led to the extraction of approximately 20 metal wire fragments, glass debris, a pen tube, and a lollipop stick. Psychiatric evaluation disclosed a diagnosis of non-suicidal self-injury (NSSI) associated with emotional distress, social phobia, and a history of bullying. This case highlights the importance of a multidisciplinary approach combining surgical, psychiatric, and psychosocial support in adolescents with somatic presentations of psychological suffering. Early recognition of NSSI and prompt intervention are crucial to prevent complications and address underlying psychopathology.